Excessive Saliva? An alternative approach..

[studentnurse]

Hi there all, before i post the main body of my enquiry i thought i'd just explain where i am coming from and who i am.

I am a final year student nurse training within the UK and currently placed out with community nurses. I have very limited knowledge of MND and as of only a few days previous, have started to become interested in possible solutions to the affects it has on peoples lives.

Within the locality i work there are several people affected by MND. One of these is a couple in their 60's, the husband suffers from bulbar MND, he is able to mobilize well with slight weight loss from muscle degeneration. He has a very poor swallow reflex and as a consequence suffers from excess saliva manifesting in episodes of drooling. The wife is somewhat superficial and refuses to let her husband out of the house as she see's his behaviour of spitting and the like as socially unacceptable to the extent that she refuses to let him out of the house citing his drooling as totally unmanagable.

I am aware that the chances the couple have to venture outdoors will in all probablility become sparse as the effects of the disease advance. The husband has been offered Radiotherapy as an 'extreme' approach to control this issue. He is currently on medication via a transdermal patch however this is not totally controlling the situation and has other side-affects.

Currently i can only see a medical or surgical approach to this problem.

My main question is to what effect other remedies such as perhaps gauze or absorbent materials have in controlling drooling as a short term 'pop out of the house' situation? To throw a completely 'way out there' question in the mix, could a small tampon inserted orally be beneficial in the above scenario given its non-toxic properties and its ability to absorb fluid?

I apologise for my ignorance of MND and thank in forsight.

Regards - Monty

[jimercat]

Monty (like the name),

A small tampon I would think might promote gag reflex. I know when my husband went to the GP for respiratory infection, the doc tried to take a look with tongue depressor and barely got in his his mouth when my husband gagged and had a choking episode. Great that you are thinking outside the box though, even if it is a tampon box!!

Has he tried Elavil or Benedryl to dry secretions? Also, cannabis is supposed to help, might help the wife more!LOL

[Al]

Hi Monty. Welcome. Interesting question on which I have no knowledge so hopefully someone else can answer. Over here we use a drug called Elavil or Amitryptiline to dry up saliva. Is it available over there?
AL.

[studentnurse]

Hi Jimercat,

Its a very valid point that you make about the gag reflex and the increased possibility of choking on anything within the mouth. We had a member of the SALT (Speech and Language Therapy) team suggest that a lot of sufferers tuck tissue inside their mouth to cope with this. Which led me to think that their must hopefully exist some other alternative of more benefit to a sufferer of MND?

Unfortunately Al, the NHS (Due to the unique way it is managed:roll: ) within his locality will not allow Amytryptiline to be prescribed for anybody not being cared for as an inpatient within hospital.

Last night i thought there was no point me blathering on about something i had little understanding or direct experience of, so having raided the girlfriends cupboard i stumbled on a bounty of various sized/strength mini tampons. I had no idea how hard it is to suppress the swallow reflex and how autonomously the body carries out this action. Anyways 30 mins down the line and i believe it worked quite well. I have no idea how many have sat there whilst the compressed cotton expands within the mouth but its generally not that off-putting.

Anyways i'll throw the ball back to see if anyone else has any suggestions.

[Steve100]

My mother is on amitriptyline...she was talking about having a dry mouth today. Maybe thats it? Any suggestions on how to combat this? (except drinking more, she struggles a bit).

Thanks

Steve

[olly]

yes.amytriptiline is used for excessive saliva,it does dry the mouth. i have been on it for 3yrs,this is worth a try,much better than inserting something in the mouth i wouldnt try that he may gag,my gag reflex is bad i gag brushing teeth.

[olly]

i drink a lot(not alcohol lol ) what dosage is she on ,i take 25mg twice a day.if its too much of a problem she may need dosage lowering.
caroline

[Steve100]

Hi Caroline, she takes 10mg in the morning and 25mg in the evening. She was prescribed Biotene 'oral balance' today so hopefully that will help. I'll see how it goes, maybe you could try it if it works :)

Steve

[Saubier]

Atropine dries up the mouth. You could make a tea from the bulbs of daffodils. I haven't tried it, so be careful. Don't use bulbs you buy; dig them up.

[c1adelman]

Does anyone have information on Atropine for excessive saliva?

[Judith]

Has anyone used Scopolamine patch for drooling? My neuro gave me a prescription for it. I haven't used it yet. Don't know if it's worth the side effects.
I am trying to find something w/o side effects. Anyone know of anything?

Judith

[BethU]

Has anyone used Scopolamine patch for drooling? My neuro gave me a prescription for it. I haven't used it yet. Don't know if it's worth the side effects.
I am trying to find something w/o side effects. Anyone know of anything?

Judith

Hi, Judith ... I started using a Transderm Scop (Scopolamine) patch two days ago, and I am amazed at how it has solved the problem. I was reluctant to try it, as I was afraid it would make my mouth very dry, but it seems to have just made the excess saliva go away without disturbing anything else, and I have not experienced any side effects (so far).

But then, as I said, I've only used it two days. But it sure works for me.
Beth

[Judith]

Hi Beth,

Thanks for your input. I am going to fill my prescription and give it a try!

Judith

[c1adelman]

My Dad used the patch and felt very anxious and jittery and very dry from it. He didn't like it at all. He also tried the Atropine drops and doesn't like them either. He uses the suction machine A LOT. This disease is horrible.... SUCKS!!!

[Judith]

My Dad used the patch and felt very anxious and jittery and very dry from it. He didn't like it at all. He also tried the Atropine drops and doesn't like them either. He uses the suction machine A LOT. This disease is horrible.... SUCKS!!!

Cladelman,

Did your Dad use a whole patch, or did he cut it and use only a portion?
My neuro said to start with 1/4 - 1/2 a patch to see how it works.
I'm suppose to p/u my prescription today. I would be interested in knowing what size portion of the patch your Dad used.

Judith

[pat-in-fl]

My mom tried the scopolamine patch (applied every 3 days) but it did not seem to work. We tried it for 1-2 weeks with no real reduction in the excessive saliva. Her MD then ordered Robinul tablets (up to 1 mg. three times a day as needed) crushed up and put throug her G tube. This really dried her secretions up quite a bit. She usually only has to take 1/2-3/4 tablet twice a day. Pat